Patient-Level, Leakage-Aware Deep Learning for Cross-Center Periapical Radiograph Classification

2026-09-13

AI Summary

本文解决了牙科影像分类中数据泄漏和跨中心验证的问题，通过使用患者级别的分组交叉验证方法，并在DentIRO数据集上比较了五种迁移学习模型。

Abstract

Dental caries and endodontic disease are among the most common health conditions worldwide, and intraoral periapical radiographs are central to their detection, treatment planning, and follow-up. Automated tooth-level classification of these images, however, lacks reproducible benchmarks, is often evaluated with image-level splits that leak patients between training and test, and is rarely validated across clinics. This paper presents the first patient-level, leakage-aware classification benchmark for single-tooth intraoral periapical radiographs on the DentIRO dataset, which comprises 5,300 images from 3,243 patients across two clinics and four classes: Healthy, Caries, Crowned, and Root Canal. Five transfer-learning models are compared with patient-grouped stratified cross-validation, so that every patient remains within a single fold. DenseNet121 gave the strongest and most stable result at a mean macro-F1 of 0.9787, while the four ImageNet-initialized backbones performed comparably. A controlled comparison on a fixed architecture showed that chest-radiograph pretraining transferred less effectively than ImageNet initialization. Bidirectional cross-center validation produced a small average generalization gap of 0.0077, and Grad-CAM confirmed that predictions rely on clinically meaningful tooth regions rather than acquisition artifacts. The benchmark offers a rigorous and reproducible baseline for intraoral radiograph classification.

Problem

• Dental Caries
• Endodontic Disease
• Intraoral Periapical Radiographs
• Automated Classification
• Cross-Clinic Validation

Innovation

• patient-level
• leakage-aware
• cross-center
• DenseNet121
• Grad-CAM